One of my favorite projects in my career was implementing an electronic health record for a community based nonprofit mental health agency.  The agency did not have an electronic health record and was going from paper records to the electronic health record.  The implementation was successful and I found the following steps and lessons learned to be helpful when implementing an EHR system.

  1. Staff involvement – It is important to get staff buy-in as early in the process as possible. Forming committees to help with the project allows staff to get comfortable with the new EHR and provide input with the set-up.  Staff members are more likely to embrace the EHR when they are part of the project and have a voice during the implementation.
  1. Find Champions – In any large project, there will be staff members that resist the change but also staff members that will embrace the change and can be your champions to help with the implementation. Try to find and identify these people as soon as possible in the process to assist in the project plan and in training staff that may not be as eager to embrace the new EHR.
  1. Create and document new processes and procedures – Working through service line processes and procedures is a time consuming process but is worth the effort. Staff need clear processes and guidelines on using the EHR system.  Without taking the time to work through these, staff may not be clear on expectations and the organization risks lost productivity, poor documentation, or missed billing.   Ensure each service line works through current processes and procedures and identifies how to complete these tasks in the EHR system.  Document these processes and procedures and train the staff on how to complete these processes in the EHR system.  I found it helpful to compare what staff did on paper to how they will do it in the EHR system so they have a framework to understand the new system.
  1. Test! Test! Test! – I cannot stress enough how important it is to test the EHR system prior to go-live – especially the billing module. I have seen organizations pay back large sums of money due to incorrect billing setup in the EHR system.  Test billing to all payers and ensure correct procedure codes, units, and rates are on all claims.  Document your testing and results for future reference.  Thorough testing also ensures timely billing and payments when the system goes live.
  1. Security – Take the time to think about the security of the EHR system and ensure staff only have access on a need-to-know basis. Ensure staff in the same job type have the same privilege levels.  Do not allow exceptions for people that you “trust” and make sure security is set by job position and not by the person in the position.  Document your security for all positions and create a grid so as new staff start, the Administrator can easily create the appropriate security level.  Also make sure processes and procedures are in place for terminating access to the EHR system when a staff member leaves the organization or is terminated.
  1. Training – Make sure all staff are trained on the new EHR system. Prior to go-live, focus training on key processes and tasks in respective service lines to ensure compliance requirements are met and billing can go out the door.  Training too many processes and tasks prior to go-live can cause staff confusion and the inability to complete required documentation and tasks.  Continue training after go-live to reaffirm processes.  As staff begin using the system and become comfortable, add additional tasks and review other areas of the system as necessary by job type until staff are fully training and comfortable.  Create a training plan/program for all new staff members that start after go-live.

Managing an EHR implementation project can seem daunting but utilizing the above steps during the project will help ease some of the stress and ensure a successful implementation.